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Let's Not Shift the War on Cancer to the War on Cancer Care

Let's not shift the war on cancer to the war on cancer care

By Nancy Davenport-Ennis, Founder and CEO of the National Patient Advocate Foundation and the Patient Advocate Foundation - 10/26/11 01:28 PM ET

The recently appointed Joint Committee on Deficit Reduction has to find at least $1.2 trillion in cuts to federal programs before the end of the year. Not an easy task by anyone’s standards. But one proposal on the table – to cut $3 billion in reimbursement to doctors who care for Medicare beneficiaries – is likely to shift the war on cancer to the war on cancer care.

On behalf of our nation’s twelve million cancer survivors, National Patient Advocate Foundation urges the Super Committee to maintain access to cancer care in the local oncologist office. Cancer patients are fighting the fight of their lives. They need access to care that is affordable, obtainable and within their means to access.

NPAF and its companion organization, Patient Advocate Foundation (PAF), helped nearly 83,000 patients in the country break through barriers to care in 2010. Seventy percent of these patients were cancer patients facing devastating financial hardships at one of the most difficult times in their life. One in four of them were Medicare patients, two-thirds had annual household incomes of less than $23,000 and many were disabled.

These are precisely the kind of patients who will be most burdened by the proposed cuts to Medicare. While at first glance the proposal appears to be a straight $3 billion cut in reimbursement to doctors, ultimately the cut will impact patients’ access to care.

Without adequate reimbursement, providers will close their doors forcing patients to either forego treatment or be relocated to inpatient facilities, many outside their communities or region.

Eighty four percent of cancer patients receive their care in community clinics – many of which are already closing.

A closed office means everyone in the community loses access to the care once provided by those nurses and physicians. According to the Community Oncology Alliance, approximately 200 community-based cancer clinics have closed in the past three years, and 389 more are struggling to survive through mergers with local hospitals. These mergers often reduce capacity to serve the overall population in the community who are facing cancer.

These projections are not merely words on the page, but have real life consequences that patient care. For example, following the enactment of the Medicare Modernization Act researchers at Duke University Clinical Research Institute working under a NPAF Global Access Project concluded that between 2003 and 2006 cancer patients in rural communities tended to have to wait up to five times longer to initiate chemotherapy after diagnosis than they did before the bill passed. (JAMA, July 2008).

The $3 billion cut before the Joint Committee to reduce payment for cancer-fighting drugs, coupled with a 30 percent Sustainable Growth Rate cut to providers scheduled to occur in January 2012 and cuts in the CMS 2012 Physician Fee Schedule, will ultimately threaten the sustainability of facilities that deliver care to Medicare patients and result in limited access to care for beneficiaries who are facing the fight of their lives.

When President Nixon signed the U.S. National Cancer Act 40 years ago, patients were heartened by this sweeping commitment and have greatly benefited from the advances in clinical care. Now, we must maintain our long-standing promise to cancer patients and once again declare the fight where it belongs – on battling cancer, not cancer care.

Nancy Davenport-Ennis is the Founder and CEO of the National Patient Advocate Foundation and the Patient Advocate Foundation and a two-time breast cancer survivor. Both organizations were founded in 1996 and have helped eliminate barriers to care for over 600,000 patients with chronic, debilitating diseases.